Fundamentals Exam 4 Flashcards by Hannah Boaz

condition in which the human being responds to changes in its normal balanced state

stress

How well did you know this?

Not at all

Perfectly

any event or stimulus that causes an individual to experience stress

stressor

How well did you know this?

Not at all

Perfectly

adjustments made in response to the stressful event

coping response

can be positive or negative

adaptation

How well did you know this?

Not at all

Perfectly

Dealing with problems and situations successfully

Coping

How well did you know this?

Not at all

Perfectly

an innate or acquired way of responding to a changing environment or specific problem or situations

coping mechanism

How well did you know this?

Not at all

Perfectly

Efforts to improve a situation by making changes or taking some action

type of coping mechanism

problem-focused

How well did you know this?

Not at all

Perfectly

Includes thoughts and actions that relieve emotional distress

type of coping mechanism

emotion-focused

How well did you know this?

Not at all

Perfectly

Smoking, Alcohol Use, Overeating, “Pill-Popping”, Excessive caffeine intake, drugs

type of coping mechanism

maladaptive

How well did you know this?

Not at all

Perfectly

a stimulus based model involving the three stressor stages

GAS (general adaptation syndrome)

How well did you know this?

Not at all

Perfectly

cortisone and epi released. Fight or flight reaction. Short lived. Mobilizes us to react.

Stage 1: alarm reaction

How well did you know this?

Not at all

Perfectly

body adapts. Attempts to limit the stressor to the smallest area of the body that can deal.

Stage 2: resistance

How well did you know this?

Not at all

Perfectly

If stress continues, coping exhausted, stress spreads to rest of body, body either returns to normal or death takes place.

Stage 3: exhaustion

How well did you know this?

Not at all

Perfectly

The 4 factors that determine if a situation is stressful

Ability to cope with stress
Practices & norms of client’s peer group
Impact of social environment to help adaptation
Resources available

How well did you know this?

Not at all

Perfectly

Decreased concentration/ attention to detail
Changes in eating, sleeping, and activity habits
Increased irritability
mistakes (poor judgment)
Lethargy/ decreased productivity

These behavioral signs of stress are…

Subtle

How well did you know this?

Not at all

Perfectly

use of chemical substances
absenteeism/illness
Emotional outbursts/crying

These behavioral signs of stress are…

More overt

How well did you know this?

Not at all

Perfectly

Name some interventions that can be used to decrease stress

Exercise/nutrition/rest
Relaxation techniques (progressive, imagery)
Time Management
Spirituality
Build support systems
Enhance self-esteem
Supportive care
establish a therapeutic relationship
Medications

How well did you know this?

Not at all

Perfectly

the knowledge that one has about oneself

self knowledge

How well did you know this?

Not at all

Perfectly

what one expects of oneself; may be realistic or unrealistic

self expectation

How well did you know this?

Not at all

Perfectly

how a person is perceived by others and society

social self

How well did you know this?

Not at all

Perfectly

the appraisal of oneself in relationship to others, events or situations

social evaluation

How well did you know this?

Not at all

Perfectly

Hospitalization threats due to stress

New roles, different views, threat to self concept, loss of privacy, financial worries.

How well did you know this?

Not at all

Perfectly

Related to actual physical gender

Related to gestures, mannerisms, dress, and vocabulary

Gender label

How well did you know this?

Not at all

Perfectly

A concern with or an interest in sexual activity
The condition of being characterized by sex of gender
The ways we experience and express ourselves as sexual beings
Influence by life experiences

Sexuality

How well did you know this?

Not at all

Perfectly

The activities that involve the body in the expression of erotic or affectionate feelings
This includes but not limited to behavior involved in reproduction

Sexual behavior

How well did you know this?

Not at all

Perfectly

Chromosomal make-up, genitalia, secondary sex characteristics, and hormonal states

Biological sex

Belief or awareness or being male or female

Gender identity

Outward expression of a person’s sense of maleness or femaleness

Gender role

the directionality of one’s sexual interest.

Sexual orientation

Focus shifts from procreation to companionship, Changing physical appearance may lead to concerns about sexual attractiveness. Need for education on normal physical changes and how to adapt. More chronic illnesses and medications. Remember: the capacity for sexuality is lifelong.

In older adults

People experience a day-night, 24 hour cycle known as the...

Circadian rhythm

``` Stage of sleep: Transition between drowsiness and sleep Only lasts a few minutes Feels as though daydreaming if awakened during this state Heart rate decreases ```

Stage 1

``` Stage of sleep: 40-50% of sleep time Can be easily awakened Muscles relax Body functions slow ```

Stage 2

``` Stage of sleep: Deep sleep Body functions continue to slow Sleep walking and bed-wetting can occur Dreams occur- often realistic ```

Stage 3

``` Stage of sleep: Both eyes move rapidly Low or absent muscle tone BP and HR fluctuate Oxygen consumption increased Dream can occur- vivid, wild, unrealistic ```

Rapid eye movement (REM)

Usual order of the sleep stages

1, 2, 3, 2, REM Usually lasting 90 min each REM lengthens throughout night

Drowsiness/sleepy, minutes, decreased heart rate Half our sleep time, easily awakened, relaxed muscles, slow body functions. Deep, sleep walking, realistic dreams

Non rapid eye movement

Inability to obtain amount of sleep one believes is necessary for healthy functioning

Insomnia

Cessation of breathing for a time during sleep

Sleep apnea

Sudden falling asleep during the daytime

Narcolepsy

Decreased quality and consistency of sleep

Sleep deprivation

Most common form. Occurs when muscles of the oral cavity or throat relax during sleep. Upper airway becomes blocked and nasal airflow stops. When awakened, voluntary control of upper airway muscles is restored and obstruction is relieved. More than 10 seconds. Causes a serious decline in arterial O2 level

Obstructive apnea

Involves defects in the brain’s respiratory control center. Impulse to breathe temporarily fails. O2 saturation falls

Central apnea

One of the most common reasons to seek medical attention

Pain

There is a lack of objective evidence in obtaining pain so it is ______ and the pain is what the patient says it is, must believe them

Subjective

Processing of painful stimuli, travel from injury to spinal column to brain where it is perceived and a response takes place.

Nociception

Suggest there are specific pain receptors in the body

Specificity theory

Bodies natural supply of opiate like substances, activated by stress or pain, occupy spots in brain where pain is perceived.

Endorpohins

Proposes that a gate control system modulates sensory input following stimulation of the skin before pain perception and response is evoked. Assumes peripheral pain fibers synapse in the spinal cord – the synapses act as “GATES” to block pain impulses when closed. Large A nerve fibers (heat, cold, and touch convey impulses through the same synapses). Ex. Give pt a backrub. If you bombard with large sensory impulses, you close the gate to the pain impulses (small C fibers are stimulated by pain).

Gate control

Reaction to pain- increased resps, increased heart rate, increased B/P, diaphoresis, pupil dilation.

Low to moderate pain (Sympathetic Nervous System stimulation)

Reaction to pain- pallor, muscle tension, decreased pulse and B/P, rapid irregular resps, May see no change in vital signs, N/V, weakness or exhaustion

Severe pain (Parasympathetic Nervous System stimulation)

``` Brief duration The end is expected Onset usually immediate may subside with or without treatment Self limiting complete relief is expected to come soon Often frightening for the client Once pain is relieved, full attention can be give towards recovery ```

Acute pain

``` Lasts a prolonged period of time May never gain relief Remissions and exacerbations Client can become frustrated and depressed Pain becomes part of client’s life ``` ``` This is a disability and can lead to job loss divorce  ability to perform ADL’s sexual dysfunction social isolation ```

Chronic pain

Can be acute, chronic or both associated with progressive malignant-type processes. May be described as intractable. Often described as all-consuming and interfering with quality of life. Examples: Arthritis Cancer

Malignant pain

Duration of time or the intensity of which a subject accepts a stimulus above the pain threshold before making a verbal or overt pain response

Pain tolerance

Intensity of the noxious stimuli necessary for the person to perceive pain

Pain threshold

Factors that increase tolerance

Alcohol/Drugs, Hypnosis, Warmth, Rubbing, Distraction, Faith, Strong beliefs. Decrease tolerance: Apprehension, Boredom, Fatigue, Anger, Weak, debilitated, Persistent pain, Stress

Loss that can be recognized by others

Actual loss

Loss that is experienced by one person but cant really be verified by others

Perceived loss

Loss experienced before the loss actually occurs

Anticipated loss

Is the total response to the emotional experience related to loss

Grief

Is the subjective response experienced by the surviving loved ones after the death of a person with whom they have shared a significant relationship

Bereavement

Is the behavioral process through which grief is eventually resolved or altered: it is often influenced by culture, spiritual beliefs, and custom

Mourning

3 types of greif

Normal Anticipatory Disenfranchised

When societal norms do not define the loss as a loss and the person does not gain support from others

Disenfranchised grief

4 tasks that promote a healthy adjustment to loss or to grief:

T- to accept the reality of the loss E- experience the pain of the loss A-adjust to the environment without that person/object in it R-reinvest the emotional energy into new relationships--cope

multidimensional, changing life force, characterized by a confident, yet uncertain expectation of achieving a goal

Hope

Developed a framework for understanding the process of dying, which is also applicable for the process of grieving. The model should be used as a guide and not rigidly adhered to. 5 stages Not every person exhibits every behavior of every stage and not every person progresses smoothly through the stages. Stages are not neat and orderly

Kubler-Ross Stages of Dying

5 stages of Kubler-Ross Stages of Dying

1. Denial- Initial reaction is one of shock and disbelief. So overwhelming that cannot deal with feelings. Example responses: “This can’t be.” “They must have made a mistake.” How nurses can help in this stage: Support patient, but don’t reinforce denial. 2. Anger- As reality slowly works it’s way into consciousness, denial no longer works and is replaced by anger. Anger may be directed at family, friends, health care workers, God… The “why me” stage. How to help: Help patient understand that the anger is a normal response, Do not take anger personally, Allow patient as much control over life as possible, Deal with needs underlying the angry reaction. 3. Bargaining- Seeks to bargain for more time in an effort to prolong the inevitable. May express feelings of guilt for past sins. Referred to as the “Yes me, but…” stage. Bargaining usually takes the form of promises. “If I can live until my child graduates, I will…” How to help: Listen and encourage patient to talk to relieve guilt and irrational fear. If appropriate, offer spiritual support 4. Depression- The “Yes, me” Stage. Client recognizes that the loss is going to happen. Will experience grief as they mourn what they are losing. May become depressed and withdraw or may talk freely. How to help: Allow to express sadness. May convey caring by touch (if appropriate) Just listen. 5. Acceptance- Comes to term with the loss. Usually neither terribly happy or sad. May begin making plans (wills, prosthesis…). Putting closure on unfinished business. How to help: Help loved ones understand the patient’s decreased need to socialize. Encourage to participate as much as possible in the treatment program

Durable power of attorney for health care | DNR Do not resuscitate

Living will

is a notarized statement appointing someone else to manage health care treatment decisions when the client is unable to do so.

Health care proxy

Stiffening of the body that occurs about 2-4 hours after death Results from lack of ATP, which causes muscles to contract and joints to immobilize, Usually leaves the body after about 96 hours

rigor mortis

Preparation of the body

``` Viewing by the family/for transport/storage Close eyelids Remove all tubes Wash body, comb hair Dress in clean gown Fresh top sheet Position flat with hand on chest, dentures in, and eyelids closed - SUPINE POSITION Disposition of belongings ```

the gradual decrease of the body’s temperature

algor mortis

RBC’s break down, releasing hemoglobin, which discolors tissues (usually in lowermost areas of body)

livor mortis

Fundamentals Exam 4 Flashcards

(74 cards)